OBJECTIVE: In order to improve the function of the anterior leaflet as a monocusp valve in tricuspid valve repair for Ebstein's anomaly, a single-stitch technique after Sebening, creating a hinge point of the anterior leaflet on the ventricular septum on the opposite side, was newly incorporated into the Hetzer operation (either posterior annulorrhaphy or the double-orifice technique). We describe the operative technique of the modified operation and present the initial results. METHODS: Eleven patients who underwent the modified operation were involved in the study. Tricuspid valve function was assessed by echocardiography preoperatively and 3 months after the operation. Its improvement was studied, and compared with that after the conventional Hetzer operation (n=15). RESULTS: After a mean follow-up period of 18.4 months (range 8.2-32.6 months), there were no early deaths and no cases of reoperation on the tricuspid valve in patients who had undergone the modified operation. At the last follow-up, 7 patients were in New York Heart Association class I, and 4 patients were in class II. The function of the tricuspid valve was significantly improved 3 months after the modified operation (P < 0.01, Wilcoxon signed-ranks test). Among the patients with Carpentier's classification type A or B, 85.7% of patients showed a tricuspid valve regurgitation (TR) grade of less than 2 after the modified operation, and this rate was significantly higher than that of 30.0% of patients in the group who underwent the conventional operation, (P < 0.05, Fisher's exact test). CONCLUSION: The initial results of the new modification are satisfactory. However, a further follow-up and an accumulation of operative cases are necessary.
OBJECTIVE: In order to improve the function of the anterior leaflet as a monocusp valve in tricuspid valve repair for Ebstein's anomaly, a single-stitch technique after Sebening, creating a hinge point of the anterior leaflet on the ventricular septum on the opposite side, was newly incorporated into the Hetzer operation (either posterior annulorrhaphy or the double-orifice technique). We describe the operative technique of the modified operation and present the initial results. METHODS: Eleven patients who underwent the modified operation were involved in the study. Tricuspid valve function was assessed by echocardiography preoperatively and 3 months after the operation. Its improvement was studied, and compared with that after the conventional Hetzer operation (n=15). RESULTS: After a mean follow-up period of 18.4 months (range 8.2-32.6 months), there were no early deaths and no cases of reoperation on the tricuspid valve in patients who had undergone the modified operation. At the last follow-up, 7 patients were in New York Heart Association class I, and 4 patients were in class II. The function of the tricuspid valve was significantly improved 3 months after the modified operation (P < 0.01, Wilcoxon signed-ranks test). Among the patients with Carpentier's classification type A or B, 85.7% of patients showed a tricuspid valve regurgitation (TR) grade of less than 2 after the modified operation, and this rate was significantly higher than that of 30.0% of patients in the group who underwent the conventional operation, (P < 0.05, Fisher's exact test). CONCLUSION: The initial results of the new modification are satisfactory. However, a further follow-up and an accumulation of operative cases are necessary.
Authors: S Chauvaud; A Berrebi; N d'Attellis; E Mousseaux; A Hernigou; A Carpentier Journal: Eur J Cardiothorac Surg Date: 2003-04 Impact factor: 4.191
Authors: R Hetzer; N Nagdyman; P Ewert; Y G Weng; V Alexi-Meskhisvili; F Berger; M Pasic; P E Lange Journal: J Thorac Cardiovasc Surg Date: 1998-04 Impact factor: 5.209
Authors: Michael V Ullmann; Sabine Born; Christian Sebening; Matthias Gorenflo; Herbert E Ulmer; Siegfried Hagl Journal: Ann Thorac Surg Date: 2004-09 Impact factor: 4.330
Authors: J M Quaegebeur; N Sreeram; A G Fraser; A J Bogers; O F Stümper; J Hess; E Bos; G R Sutherland Journal: J Am Coll Cardiol Date: 1991-03-01 Impact factor: 24.094
Authors: A Carpentier; S Chauvaud; L Macé; J Relland; S Mihaileanu; J P Marino; B Abry; P Guibourt Journal: J Thorac Cardiovasc Surg Date: 1988-07 Impact factor: 5.209